Mobilization of stem cell: past, present and future

Abstract

This article reflects the main stages of development of high-dose chemotherapy with autologous stem cell as an effective method of treatment of various hematological, oncological and hereditary diseases. It describes the development of the research beginning with the discovery of the stem cells by A.A Maksimov to the contemporary ways to elaborate them into blood; it reflects the basic mechanisms of action of different groups of drugs on complex biochemical cascades close interaction with hematopoietic cells of the bone marrow microenvironment, which, in turn, determines their further destiny and lead to a loss of hematopoietic stem cells in peripheral blood. However, in spite of the current approaches to improve ways of harvesting stem cell, there is a certain percentage of patients in whom it is impossible to collect adequate for quick recovery of hematopoiesis after high-dose chemotherapy number of cells. This percentage will vary according to various literature sources, 5 to 40 %. Therefore, the development and application of new drugs, growth factors and cytokines, which would overcome the problem of poor mobilization is an important issue in modern medicine. The article presents data on the use of a new mobilizing agent plerixafor, the use of which in practice improves the successful mobilization of 40 %. The study of its combined action of various growth factors, including pegylated filgrastim, is a promising direction, because can be a good option for patients with poor mobilization activity for which the previous regimen mobilization proved ineffective. The research of plerixafor interacting with various growth factors including pegylated filgrastim is considered to be the most promising direction. This method is believed to help patients with low mobilizing activity where all other means have failed to improve it.